Employment Application

If you include a resume, completion of the fields below is completely optional.

Further Information

Date Available

Desired Salary

Experience & Knowledge for this Position

Special Skills Applicable to Position

Are you a citizen of the United States?

If no, are you authorized to work in the U.S.?

Would you be willing to relocate?

If yes, explain

Have you worked for one or more of our companies before?

If so, which and when?

Have you ever been convicted of a felony?

If yes, explain

Education History

High School

City, State

From

To

Did you graduate?

College

City, State

From

To

Did you graduate?

Degree

College

City, State

From

To

Did you graduate?

Degree

Briefly Describe Your Career Objectives

Special Training, Experience, or Pertinent Data

How Did You Hear About Us?

Military Service

Branch

From

To

Rank at Discharge

Type of Discharge

If Other than Honorable, Explain

Previous Employment

List Present or Most Recent Employer First

Company

Address

Supervisor

Phone

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?
Yes
No

Company

Address

Supervisor

Phone

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?
Yes
No

Company

Address

Supervisor

Phone

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?
Yes
No

Company

Address

Supervisor

Phone

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?
Yes
No

Resumes will be kept on file. Only candidates selected for interviews will be contacted.

Piggly Wiggly Alabama Distributing Company is an Equal Opportunity employer and is proud to have a drug-free environment. All employment offers are contingent upon applicant successfully completing drug and background screenings.